Alfred ECMO Guideline
2020年4月18日 · We are a tertiary Intensive Care Unit in Melbourne, Australia with a comprehensive ECMO service since 2003 and a 24/7 ECPR program since 2012. You can find more information on our website The Alfred ICU and …
ECMO initiation – Alfred ECMO Guideline
ECMO initiation comprises the process of establishing the patient on ECMO support. Additional specific emergency instructions for ECPR can be found under ECPR initiation. Patient eligibility. VA ECMO; VV ECMO; ECPR; ECMO console set up (see below) ROLE Cards. Patient preparation. Patient positioning and explanations; Bedside US sizing of vessels
ECMO circuit change – Alfred ECMO Guideline
Common reasons to exchange the ECMO circuit are clot accumulation with or without rise in Delta P. This may be associated with coagulation system activation and inflammation e.g. with rising D-Dimer and falling fibrinogen (< 2).
Configurations of ECMO – Alfred ECMO Guideline
The Configuration of ECMO refers to the cannula insertion site, type, tip position and size used in a particular mode. Commonly used configurations are described below.
INCLUSION Criteria – Alfred ECMO Guideline
If the patient is ineligible for ECMO initiation by not fulfilling ALL minimum criteria, but the procedural cardiologist considers them appropriate, the patient should be discussed with the ECMO ICU consultant prior to the cath lab procedure commencing.
Transport & Retrieval – Alfred ECMO Guideline
ECMO retrieval. Transport of patients requiring ECMO is feasible and safe if undertaken with care and diligence. Critically unwell patients requiring maximal ventilatory or circulatory support often destabilise during transfers. Increased patient stability once established on ECMO support facilitates safe transfer to an ECMO centre for ongoing ...
Level of ECMO support – Alfred ECMO Guideline
Assess adequacy of ECMO support and setting. For VV ECMO target blood flows must provide adequate arterial oxygenation while allowing non-injurious lung ventilation. For VA ECMO target blood flows in combination with the native cardiac function must provide adequate systemic cardiac output and oxygen delivery. VA ECMO support must also allow ...
Patient and ECMO monitoring – Alfred ECMO Guideline
Visual inspection can provide a very quick overview of the ECMO support. Patient status on the monitor, oxygen saturation and degree of pulsatility; Presence of colour differential in the ECMO tubing; Display panel on the console; Visual inspection of the cannula site and circuit
ECMO Guideline – Alfred ECMO Guideline
Configurations of ECMO; Patient Safety Rules; Equipment Used; Clinical Application of ECMO. When to think about ECMO? Principles of patient selection; Specifics of patient selection. VA ECMO; VV ECMO; ECPR; Internal referrals; External referrals to the ECMO centre; VA ECMO. Patient selection; ECMO initiation; Distal perfusion cannula [DPC] Loss ...
Principles of patient selection – Alfred ECMO Guideline
All ECMO admissions to ICU are at the discretion of the ICU ECMO Clinical Service. Selecting the right patient for ECMO at the right time is frequently complex. It involves weighing up multiple different factors (see table below).